Jane Gross shared a story where her mother uttered the phrase, "We live too long and die too slowly." If you have aging parents or are planning on aging someday yourself, I recommend her book A Bittersweet Season, Caring for Our Aging Parents --and Ourselves. Jane's mother in her late 80s had many things that were "wrong with her" but none of them were killing her. Prolonged senescence introduces frailty in a way that we, as a society, aren't prepared to manage either as caregivers or healthcare providers.

The medicalization of aging launches a long slow death with only a passing nod to quality of life. I was reminded of her book while reading a recent New Yorker article by Atul Gawande, Overkill, An avalanche of unnecessary medical care is harming patients physically and financially. What can we do about it. I blog specifically about the specificity of economics, culture , and history in Alzheimer's Disease but even generalized geriatric care on the far horizon of aging isn't being discussed in a meaningful way.

The virtuous patient is up against long odds, however. One major problem is what economists call information asymmetry. In 1963, Kenneth Arrow, who went on to win the Nobel Prize in Economics, demonstrated the severe disadvantages that buyers have when they know less about a good than the seller does. His prime example was health care. Doctors generally know more about the value of a given medical treatment than patients, who have little ability to determine the quality of the advice they are getting. Doctors, therefore, are in a powerful position. We can recommend care of little or no value because it enhances our incomes, because it’s our habit, or because we genuinely but incorrectly believe in it, and patients will tend to follow our recommendations.

is not just consuming a third of health-care spending; it’s costing people’s lives. As long as a more thoughtful, more measured style of medicine keeps improving outcomes, change should be easy to cheer for. Still, when it’s your turn to sit across from a doctor, in the white glare of a clinic, with your back aching, or your head throbbing, or a scan showing some small possible abnormality, what are you going to fear more—the prospect of doing too little or of doing too much?--Atul Gawande

The podcast below is a replay of an earlier show (the New Old Age Blog in NY Times has been updated) it contextualizes discussions of caring for our aging parents and society in general in a meaningful and inspiring way.

Thoughtful discussions about content development and outcomes analytics that apply the principles and frameworks of health policy and economics to persistent and perplexing health and health care problems